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GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
RAJYASABHA
UNSTARREDQUESTION NO. 3632
TOBE ANSWERED ON24TH MARCH, 2026
DE-EMPANELMENTOFHOSPITALSUNDER AYUSHMAN BHARAT–PMJAY
3632. DR. JOHNBRITTAS:
Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate:
(a) the number and details of hospitals de-empanelled and penalised under the Ayushman
Bharat - PMJAYscheme during the last five years, detailsthereof,year-wise andState-wise;
(b) the main grounds for such de-empanelment, including fraud, overbilling and procedural
violations;
(c)the totalamount involvedtherein;
(d) the totalamountrecovered insuch cases till date;
(e)the penaltiesimposed andrecoveredinsuch cases till date; and
(f) the measures taken to strengthen monitoring, prevent misuse of public funds and ensure
uninterruptedaccesstoquality healthcarefor beneficiaries?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND
FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a) to (f): Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY),
hospital empanelment is a continuous process and is undertaken by the implementing
State/UT based on the requirements and availability of healthcare providers meeting the
criteria within a given State/UTasperempanelment guidelinesof National HealthAuthority.
As on 10.03.2026, 2021 hospitals have been de-empanelled and penalties amounting to Rs
263.72crore have beenlevied onempanelledhospitals for fraudulent activities.
AB-PMJAY is governed on a zero-tolerance approach towards fraud. National Anti-Fraud
Unit (NAFU) uses AI/ML-based automated triggers to flag unusual claim patterns such as
duplicateentries,inflatedprocedures,ormisuseofpatientidentityetc.
NAFU works in close coordination with the State Anti-Fraud Units to investigate and take
action against cases of fraud. Appropriate actions including suspension, de-empanelment,
levyingpenalty, lodgingof FIRs, etc.are taken against hospitals for fraudulent activities.
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